Midwest Medicorp, SC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

036096853 Issued in IL

Legal business name

MIDWEST MEDICORP, SC

Practice address

6524 W Archer Ave
Chicago, IL 60638-2400

Phone

(773) 229-9600

Fax

(773) 229-9611

NPI assigned

Oct 3, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ali Rafie-Safaie, DC

Title

Manager

Phone

(773) 229-9600

Specialties & licenses 3

Addresses

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James R Diesfeld, M.D.

  • Interventional Pain Medicine Physician
  • Chicago, IL
  • NPI 1497753214
  NPD (past)
• Emily Fenton

  • Physician Assistant
  • Chicago, IL
  • NPI 1285003079
  NPD (past)
• Brandy Lynn Hanson, FNP-BC

  • Family Nurse Practitioner
  • Chicago, IL
  • NPI 1467945840

  Multi-Specialty

  NPD (past)
• Yolanda Peraza Zaragoza-Diesfeld, L.C.S.W.

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1184804627
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312416000000",
    "number": "1124112461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6524 W ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606382400",
            "telephone_number": "773-229-9600",
            "fax_number": "773-229-9611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6524 W ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606382400",
            "telephone_number": "773-229-9600",
            "fax_number": "773-229-9611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST MEDICORP, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2011-08-04",
        "status": "A",
        "authorized_official_last_name": "RAFIE-SAFAIE",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-229-9600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036096853",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016004709",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Midwest Medical Services Inc
• Midwest Medical Services Inc
• Midwest Medical Supplies & Equipment LLC
• Midwest Medical Supply & Equipment, Inc.
• Midwest Medical Transport Inc
• Midwest Medix Surgery Center
• Midwest Mobile Diagnostics LLC
• Midwest Neurolodiagnostic Specialists
• Midwest Neuropsychiatric Assoc LTD
• Midwest NP Care Services SC

• Physical Medicine & Rehabilitation Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Physical Medicine & Rehabilitation Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.